Bahadori Atessa, Wilhelm-Bals Alexandra, Caccia Julien, Chehade Hassib, Goischke Alexandra, Habre Céline, Marx-Berger Daniela, Nef Samuel, Sanchez Oliver, Spartà Giuseppina, Vidal Isabelle, von Vigier Rodo O, Birraux Jacques, Parvex Paloma
Nephrology Unit, Paediatric Specialties Division, Geneva University Hospitals (HUG), 1205 Geneva, Switzerland.
Division of Paediatric Nephrology, Department of Paediatrics, The Hospital for Sick Children, University of Toronto, Toronto, ON M5G 1E8, Canada.
Children (Basel). 2024 Dec 23;11(12):1561. doi: 10.3390/children11121561.
Urinary tract dilations (UTDs) are the most frequent prenatal renal anomaly. The spectrum of etiologies causing UTD ranges from mild spontaneously resolving obstruction to severe upper and lower urinary tract obstruction or reflux. The early recognition and management of these anomalies allows for improved renal endowment prenatally and ultimately better outcome for the child. The role of the general obstetrician and pediatrician is to recognize potential prenatal and postnatal cases addressed to their practice and to refer patients to specialized pediatric nephrology and urology centers with a sense of the urgency of such a referral. The aim of this paper is to offer clinical recommendations to clinicians regarding the management of neonates and children born with prenatally detected UTD, based on a consensus between Swiss pediatric nephrology centers. The aim is to give suggestions and recommendations based on the currently available literature regarding classifications and definitions of prenatal and postnatal UTD, etiologies, prenatal and postnatal renal function evaluation, investigations, antibiotic prophylaxis, and the need for referral to a pediatric nephrologist and/or urologist. The overarching goal of a systematic approach to UTD is to ultimately optimize kidney health during childhood and improve long-term renal function prognosis.
尿路扩张（UTD）是最常见的产前肾脏异常。导致UTD的病因范围从轻度自发缓解的梗阻到严重的上尿路和下尿路梗阻或反流。对这些异常的早期识别和管理有助于改善产前肾脏禀赋，并最终为患儿带来更好的结局。普通产科医生和儿科医生的职责是识别其业务范围内潜在的产前和产后病例，并在意识到此类转诊紧迫性的情况下，将患者转诊至专业的儿科肾脏病和泌尿外科中心。本文旨在基于瑞士儿科肾脏病中心之间的共识，为临床医生提供有关管理产前检测出UTD的新生儿和儿童的临床建议。目的是根据目前关于产前和产后UTD的分类和定义、病因、产前和产后肾功能评估、检查、抗生素预防以及转诊至儿科肾脏病专家和/或泌尿外科专家的必要性的现有文献，给出建议。对UTD采取系统方法的总体目标是最终在儿童期优化肾脏健康并改善长期肾功能预后。
